A scoping review of retail environment interventions and their impacts on health and wellbeing

BACKGROUND: ‘High streets’ and town centres are influential in shaping health. In recent years many countries implemented policies to revitalise and financially support retail environments. The aim of this scoping review is to systematically map evidence on retail environment interventions, to gain an understanding of their possible health and wellbeing impacts. This review identifies types of interventions, the health outcomes they address and the associated theories of change. METHODS: Peer-reviewed studies in English were identified through five academic databases using search terms for relevant initiatives and health and wellbeing outcomes. Grey literature was identified online and through citation scanning. Studies were eligible if they evaluated interventions with a significant focus on supporting the retail environment, reporting on at least one health and wellbeing outcome. Extracted data were presented descriptively. Theories of change were analysed using an interpretive approach. RESULTS: Of 6,752 identified evaluations, 53 peer-reviewed studies and 10 grey literature reports were included. Interventions types were area-based initiatives, business improvement districts, business incentives, and demand-side incentives. The most common outcomes were social and environmental determinants of health, although impacts on physical health, mental health, and food consumption and purchasing were also studied. Most interventions involved partnerships with the private sector or were ‘whole-of-society’ initiatives. Evidence for the effectiveness of interventions was mixed, depending on the type of intervention. Theories of change were found to be reductionist and often did not account for context-specific factors. CONCLUSIONS: To our knowledge, this is the first review of literature evaluating the health impacts of interventions aimed at revitalising retail environments. Future interventions should more comprehensively address economic, health and social outcomes. KEY MESSAGES: • High street environments are influential in shaping health, and initiatives aimed at supporting local businesses should consider health and social objectives. • Most literature to date evaluates social and environmental outcomes of retail environment interventions rather than more direct health and wellbeing outcomes.